title: Wikis and collaborative writing applications in health care: a scoping review.
abstract: BACKGROUND
  Collaborative writing applications (eg, wikis and Google Documents) hold the potential to improve the use of evidence in both public health and health care. The rapid rise in their use has created the need for a systematic synthesis of the evidence of their impact as knowledge translation (KT) tools in the health care sector and for an inventory of the factors that affect their use.
  
  
  OBJECTIVE
  Through the Levac six-stage methodology, a scoping review was undertaken to explore the depth and breadth of evidence about the effective, safe, and ethical use of wikis and collaborative writing applications (CWAs) in health care.
  
  
  METHODS
  Multiple strategies were used to locate studies. Seven scientific databases and 6 grey literature sources were queried for articles on wikis and CWAs published between 2001 and September 16, 2011. In total, 4436 citations and 1921 grey literature items were screened. Two reviewers independently reviewed citations, selected eligible studies, and extracted data using a standardized form. We included any paper presenting qualitative or quantitative empirical evidence concerning health care and CWAs. We defined a CWA as any technology that enables the joint and simultaneous editing of a webpage or an online document by many end users. We performed qualitative content analysis to identify the factors that affect the use of CWAs using the Gagnon framework and their effects on health care using the Donabedian framework.
  
  
  RESULTS
  Of the 111 studies included, 4 were experimental, 5 quasi-experimental, 5 observational, 52 case studies, 23 surveys about wiki use, and 22 descriptive studies about the quality of information in wikis. We classified them by theme: patterns of use of CWAs (n=26), quality of information in existing CWAs (n=25), and CWAs as KT tools (n=73). A high prevalence of CWA use (ie, more than 50%) is reported in 58% (7/12) of surveys conducted with health care professionals and students. However, we found only one longitudinal study showing that CWA use is increasing in health care. Moreover, contribution rates remain low and the quality of information contained in different CWAs needs improvement. We identified 48 barriers and 91 facilitators in 4 major themes (factors related to the CWA, users' knowledge and attitude towards CWAs, human environment, and organizational environment). We also found 57 positive and 23 negative effects that we classified into processes and outcomes.
  
  
  CONCLUSIONS
  Although we found some experimental and quasi-experimental studies of the effectiveness and safety of CWAs as educational and KT interventions, the vast majority of included studies were observational case studies about CWAs being used by health professionals and patients. More primary research is needed to find ways to address the different barriers to their use and to make these applications more useful for different stakeholders.
authors.affiliation: Département de médecine familiale et médecine d'urgence, Université Laval, Québec, QC, Canada. patrick.m.archambault@gmail.com.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Archambault
authors.forename: Tom H
authors.initials: TH
authors.lastname: van de Belt
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Grajales
authors.forename: Marjan J
authors.initials: MJ
authors.lastname: Faber
authors.forename: Craig E
authors.initials: CE
authors.lastname: Kuziemsky
authors.forename: Susie
authors.initials: S
authors.lastname: Gagnon
authors.forename: Andrea
authors.initials: A
authors.lastname: Bilodeau
authors.forename: Simon
authors.initials: S
authors.lastname: Rioux
authors.forename: Willianne L D M
authors.initials: WL
authors.lastname: Nelen
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Gagnon
authors.forename: Alexis F
authors.initials: AF
authors.lastname: Turgeon
authors.forename: Karine
authors.initials: K
authors.lastname: Aubin
authors.forename: Irving
authors.initials: I
authors.lastname: Gold
authors.forename: Julien
authors.initials: J
authors.lastname: Poitras
authors.forename: Gunther
authors.initials: G
authors.lastname: Eysenbach
authors.forename: Jan A M
authors.initials: JA
authors.lastname: Kremer
authors.forename: France
authors.initials: F
authors.lastname: Légaré
mesh_terms: D003299:Cooperative Behavior; D003695:Delivery of Health Care; D006801:Humans; D020407:Internet; D014956:Writing
keywords: Google Docs; Google Knol; Internet; Web 2.0; Wiki; Wikipedia; collaborative authoring; collaborative writing applications; crowdsourcing; ehealth; evidence-based medicine; knowledge management; knowledge translation; medical informatics; participatory med